Division of Human Nutrition and Health, Wageningen University & Research, P.O. Box 17, Wageningen, 6700 AA, The Netherlands.
Centre for Prevention, Lifestyle and Health, National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, Bilthoven, 3721 MA, The Netherlands.
Eur J Nutr. 2024 Dec;63(8):2957-2973. doi: 10.1007/s00394-024-03477-w. Epub 2024 Aug 24.
Investigate the associations of ultra-processed foods (UPF) in healthful (hPDI) and unhealthful (uPDI) plant-based diets with all-cause mortality, greenhouse gas emissions (GHGE), and blue water consumption (BWC).
Analyses were based on 35,030 participants (20-70 years; 74% females) from the EPIC-NL cohort who were followed up from 1993 to 1997 through 2014. Plant-based diet indices (hPDI and uPDI) and UPF consumption were calculated from a validated FFQ, assessed at baseline. Cox proportional hazard and multiple linear regression models were used to estimate associations between combined quartiles of the PDI indices and UPF consumption.
With lower hPDI and higher UPF diets as the reference, we observed the following. Risk estimates of all-cause mortality were 0.98 (95% CI: 0.83, 1.16) for lower UPF consumption, 0.86 (95% CI: 0.68, 1.08) for higher hPDI, and 0.78 (95% CI: 0.66, 0.89) for combined higher hPDI and lower UPF consumption. Results with the uPDI were inconclusive. Mean differences in GHGE and BWC were 1.4% (95% CI: 0.3, 2.4) and 1.6% (95% CI: -0.5, 3.7) for lower UPF consumption, -7.4% (95% CI: -8.6, -6.4) and 9.6% (95% CI: 7.2, 12.0) for higher hPDI, and - 6.8% (95% CI: -7.4, -6.1) and 13.1% (95% CI: 11.6, 14.8) for combined higher hPDI and lower UPF consumption. No apparent conflict between environmental impacts was observed for the uPDI; GHGE and BWC were lower for higher uPDI scores.
Mortality risk and environmental impacts were mostly associated with the amount of plant-based foods and to a lesser extent UPF in the diet. Shifting to a more healthful plant-based diet could improve human health and reduce most aspects of environmental impact (GHGE, but not BWC) irrespective of UPF consumption.
研究健康植物性饮食（hPDI）和不健康植物性饮食（uPDI）中超加工食品（UPF）与全因死亡率、温室气体排放（GHGE）和蓝水消耗（BWC）的关联。
分析基于 EPIC-NL 队列的 35030 名参与者（20-70 岁；74%为女性），从 1993 年至 1997 年通过 2014 年进行随访。基于经过验证的 FFQ 计算 hPDI 和 uPDI 以及 UPF 消耗，在基线时进行评估。使用 Cox 比例风险和多元线性回归模型来估计 PDI 指数和 UPF 消耗的组合四分位数之间的关联。
以低 hPDI 和高 UPF 饮食为参照，我们观察到以下结果。全因死亡率的风险估计值分别为：低 UPF 消耗组为 0.98（95%CI：0.83，1.16），高 hPDI 组为 0.86（95%CI：0.68，1.08），高 hPDI 和低 UPF 消耗组为 0.78（95%CI：0.66，0.89）。uPDI 的结果不确定。低 UPF 消耗组的 GHGE 和 BWC 的平均差异分别为 1.4%（95%CI：0.3，2.4）和 1.6%（95%CI：-0.5，3.7），高 hPDI 组分别为-7.4%（95%CI：-8.6，-6.4）和 9.6%（95%CI：7.2，12.0），高 hPDI 和低 UPF 消耗组分别为-6.8%（95%CI：-7.4，-6.1）和 13.1%（95%CI：11.6，14.8）。对于 uPDI，未观察到环境影响之间明显的冲突；较高的 uPDI 评分与较低的 GHGE 和 BWC 相关。
死亡率风险和环境影响主要与饮食中的植物性食物数量有关，而与超加工食品（UPF）的关系较小。转向更健康的植物性饮食可以改善人类健康并减少大多数环境影响（GHGE，但不包括 BWC），而与 UPF 的消耗无关。
